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Utilization Management Coordinator - Registered Nurse (RN)
HCSC - Chicago, IL
BASIC FUNCTION: This position is responsible performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness and quality of medical/surgical services and serving as liaison between providers and Medical and Network Management Divisions. This position reviews service requests, collects clinical and n...
Reimbursement Specialist
HCSC - Chicago, IL
Job Purpose The Reimbursement Specialist is responsible for interpreting contract language to identify, implement and configure contract rates and provisions into Enterprise Pricing/Discounting and Reconciliation applications and systems for all lines of business (current and future) to ensure that BCBSIL network facilities receive accurate and timely co...
LTD Claims Analyst (Dearborn Group)
HCSC - Portland, ME
LTD Claims Analyst (ME, IL, TX) Job Purpose: Obtains and analyzes information to make claim decisions and payments on disability claims. Develops and applies appropriate claim and disability management techniques to ensure prompt and accurate payment and liability management of disability claims. Provides responsive customer service to claimants, policyholders, brokers, ...
Executive Communications Consultant III
HCSC - Richardson, TX
BASIC FUNCTION: This position is responsible for developing executive communications for a variety of senior leaders and divisions and will have interaction with key stakeholders, subject matter experts and management at all levels of the organization. This position will organize and develop content and presentations for leadership meetings and town halls, d...
Analytics & Reporting Analyst
HCSC - Chicago, IL
Basic Function The Analytics & Reporting Analyst will be analyzing commercial and government provider agreements to establish reporting, develop compensation grids, and create provider file updates. The role is part of our IL Plan Division, and more specifically on our Network Reimbursement Operations Team. The Analyst will work closely with ...
Wellbeing Health Advisor
HCSC - Helena, MT
Work-from-home may be an option. Job Purpose: This position will be responsible for focusing on the overall health of the member by assisting the member with the goal of increased health and overall wellbeing by developing a one-to-one relationship with the member. Encourage members to utilize appropriate resources and web-based tools available to them to access info...
Sr Infrastructure Service Delivery Analyst - Network
HCSC - Richardson, TX
As the health care industry continues to rapidly transform, our IT team conceives, develops and delivers impactful technology solutions to support access to quality, affordable health care for our members. We are driven by our collective company purpose: To do everything in our power to stand with our members in sickness and in health®. Our IT team unleashes the power of this p...
Sr Systems Analyst - Java/Oracle
HCSC - Chicago, IL
As the health care industry continues to rapidly transform, our IT team conceives, develops and delivers impactful technology solutions to support access to quality, affordable health care for our members. We are driven by our collective company purpose: To do everything in our power to stand with our members in sickness and in health®. Our IT team unleashes the pow...
Sr Business Architect
HCSC - Chicago, IL
As the health care industry continues to rapidly transform, our IT team conceives, develops and delivers impactful technology solutions to support access to quality, affordable health care for our members. We are driven by our collective company purpose: To do everything in our power to stand with our members in sickness and in health®. Our IT team unleashes the pow...
Process Consultant II
HCSC - United States of America
JOB PURPOSE: This position is responsible for supporting Customer Service Leadership in planning, defining, tracking, developing, testing, documenting, analyzing results and/or implementing Process Improvement and Process Reengineering opportunities. Providing guidance, and support for Business Process activities. Supporting team activities, deliverables, and issue resoluti...
Lead Learning & Development Specialist
HCSC - Richardson, TX
Job Purpose This position will collaborate with learning business partners, business subject matter experts, stakeholders and others to understand business performance gaps and learning needs. The Learning Partner will manage overall curricula project initiatives, including partnering with instructional designers to formulate design strategy, detailed ne...
Digital Analyst - Digital Product Analytics & Insights
HCSC - Richardson, TX
As the health care industry continues to rapidly transform, our IT team conceives, develops and delivers impactful technology solutions to support access to quality, affordable health care for our members. We are driven by our collective company purpose: To do everything in our power to stand with our members in sickness and in health®. Our IT team unleashes the pow...
Cybersecurity Analyst
HCSC - Richardson, TX
As the health care industry continues to rapidly transform, our IT team conceives, develops and delivers impactful technology solutions to support access to quality, affordable health care for our members. We are driven by our collective company purpose: To do everything in our power to stand with our members in sickness and in health®. Our IT team unleashes the power of this p...
Clinical Process Improvement Specialist (RN)
HCSC - Richardson, TX
We are the Health Care Management division of HCSC — a team of dedicated nurses, doctors and other clinicians. Everything we do, and every decision we make, aims to help our members live their most healthy lives. We treat the whole person with integrated pharmacy, physical and mental health care benefits. We're also tackling the social determi...
Benefit Value Advisor
HCSC - Dallas, TX
This is not a remote position! This job will be located in Dallas, TX. BASIC FUNCTION: Under supervision, this position is responsible for working on the phone 90% of the day at the C1 Innovation Lab to assist members and physicians by responding to telephone and written inquiries in a prompt, accurate and objective manner. Du...
